US10549119B2 - Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters - Google Patents
Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters Download PDFInfo
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- US10549119B2 US10549119B2 US16/255,086 US201916255086A US10549119B2 US 10549119 B2 US10549119 B2 US 10549119B2 US 201916255086 A US201916255086 A US 201916255086A US 10549119 B2 US10549119 B2 US 10549119B2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/103—Treatment planning systems
- A61N5/1031—Treatment planning systems using a specific method of dose optimization
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1042—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy with spatial modulation of the radiation beam within the treatment head
- A61N5/1045—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy with spatial modulation of the radiation beam within the treatment head using a multi-leaf collimator, e.g. for intensity modulated radiation therapy or IMRT
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1077—Beam delivery systems
- A61N5/1081—Rotating beam systems with a specific mechanical construction, e.g. gantries
Definitions
- This invention relates generally to radiation-treatment planning.
- radiation therapy comprises an important component of many treatment plans for reducing or eliminating unwanted tumors.
- applied radiation does not discriminate between unwanted structures and adjacent tissues, organs, or the like that are desired or even critical to continued survival of the patient.
- radiation is ordinarily applied in a carefully administered manner to at least attempt to restrict the radiation to a given target volume.
- Arc therapy for example, comprises one such approach.
- a radiation-treatment plan therefore often provides information regarding useful or necessary adjustments to the radiation-treatment platform during such a treatment.
- the radiation beam is flattened using one or more flattening filters. Notwithstanding this flattening, a typical treatment plan endeavors to ensure that the isocenter of each administered beam is the same (and typically in the center of the beam) regardless of the administration angle and other field considerations. Unfortunately, this often leads to higher intensity in the middle of the planned treatment volume and a resultant wasting of energy in order to assure the right overall dose distribution.
- FIG. 1 comprises a schematic representation as configured in accordance with the prior art
- FIG. 2 comprises an energy flux profile as configured in accordance with the prior art
- FIG. 3 depicts an opening ration matrix as configured in accordance with the prior art.
- FIG. 4 comprises a side-elevational schematic representation as configured in accordance with the prior art
- FIG. 5 depicts energy flux profiles as configured in accordance with the prior art
- FIG. 6 comprises a flow diagram as configured in accordance with various embodiments of the invention.
- FIG. 7 comprises an energy flux profile as configured in accordance with various embodiments of the invention.
- FIG. 8 depicts an opening ratio matrix as configured in accordance with various embodiments of the invention.
- FIG. 9 comprises a side-elevational schematic representation as configured in accordance with various embodiments of the invention.
- FIG. 10 depicts energy flux profiles as configured in accordance with various embodiments of the invention.
- FIG. 11 comprises a schematic representation as configured in accordance with various embodiments of the invention.
- FIG. 12 comprises a block diagram as configured in accordance with various embodiments of the invention.
- a control circuit utilizes patient information and treatment-platform information to optimize a radiation-treatment plan by permitting isocenters of various radiation-treatment fields as comprise parts of a same treatment plan to not be coincidental with one another to thereby yield an optimized treatment plan.
- the patient information can pertain to one or more physical aspects of the patient as desired.
- the foregoing can comprise scattering the isocenters of the various radiation-treatment fields around a predetermined point (such as, for example, the center of the treatment volume).
- this approach can comprise causing an area of highest energy flux for a given field to be non-coincident with at least some of the other radiation-treatment fields that are also specified by the radiation-treatment plan.
- the aforementioned radiation-treatment plan can comprise, by one approach, an intensity-modulated radiation-therapy plan.
- This can include intensity-modulated radiation-therapy plans that presume nonuse of a radiation beam-flattening filter.
- a desired dosage distribution can often be attained in a more efficient manner (i.e., with less energy wastage) than has been achieved in the past with traditional approaches that seek to ensure that the beam isocenters for various fields as collectively comprise a radiation-treatment session are fully or at least substantially coincident with one another.
- the corresponding calculations to form such a plan are not unduly complicated nor likely to significantly extend the amount of time a given plan-optimization methodology may require to iterate and identify a resultant plan.
- FIG. 1 illustrates, for example, a treatment volume 100 (such as a patient's organ, tumor, or tissue of concern) undergoing radiation treatment.
- the isocenter 101 of the radiation beam for each treatment field is the same.
- the isocenter is the point in space through which the central ray of the radiation beams pass.
- this isocenter 101 is both the radiation isocenter (i.e., the center of the beam) and also the mechanical isocenter (i.e., the point where the center rays of the radiation beams for all of the treatment fields intersect).
- FIG. 2 depicts an energy flux profile 202 across a prior-art radiation beam (presuming a flattening-filter-free mode of operation).
- the actual shape will of course depend on the energy used and the point where the flux profile (at the location where the total ascension is largest) begins to decrease rapidly (i.e., the so-called field edge) (to, for example, around thirty to sixty percent of the peak value).
- the required energy fluence 201 is flat.
- the extra flux will typically be blocked using jaws, one or more multi-leaf collimators, or the like.
- FIG. 3 depicts a corresponding opening ratio matrix 301 .
- the two peaks will typically be formed separately. This, in turn, typically leads to a lost monitor unit (MU) factor of about 1.2 that is attributable to the amount of the total ascension of the opening ratio matrix 301 curve.
- MU lost monitor unit
- FIG. 4 exemplifies a simple intensity-modulated radiation-therapy (IMRT) treatment that comprises a first radiation beam 401 and a second, opposing radiation beam 402 .
- IMRT intensity-modulated radiation-therapy
- the illustrated example typifies prior art practice in these regards and hence the two beams 401 and 402 share a common isocenter 101 that is, in turn, located at the center of a planned treatment volume 100 .
- FIG. 5 illustrates the required energy fluxes 202 to produce a flat dose distribution within this planned treatment volume 100 . (Those skilled in the art will note that there are some degrees of freedom to split the flux between these two fields, but the illustrated example represents a typical view of a most-efficient configuration in these regards.)
- FIG. 6 an illustrative process 600 that runs contrary to many of the key presumptions of the foregoing will be presented. This process 600 can be carried out, for example, by a control circuit of choice. Further elaboration in those regards will be provided below.
- this process 600 provides for accessing patient information regarding at least one physical aspect of a given patient.
- the specific nature of the patient information can of course vary from patient to patient and with respect to the nature of the patient's treatment requirements. Examples include but are not limited to information regarding the patient's geometry (or sub-geometry as pertains to portions of interest), physical orientation, and the relative positions of specific organs, tissues, and biological subsystems, to note but a few.
- This patient information can include relatively static information that does not change much over time as well as relatively dynamic information that changes slowly or quickly over time (such as a growing or shrinking tumor on the one hand or an expanding/contracting lung on the other hand).
- relatively static information that does not change much over time as well as relatively dynamic information that changes slowly or quickly over time (such as a growing or shrinking tumor on the one hand or an expanding/contracting lung on the other hand).
- this process 600 also provides for accessing treatment-platform information.
- This information can vary with the application setting. Examples in these regards include details regarding the nature and strength of the radiation source, dimensions and details regarding a gantry that holds and transports the radiation source during a treatment session, the number, type, and capabilities of collimators, jaws, and the like as may be available, the dimensions and orientation of the patient-support surface, and so forth. Again the present teachings are not overly sensitive to any particular choices in these regards and therefore further details will not be provided here for the sake of brevity and clarity.
- this process 600 then uses the foregoing patient information and treatment-platform information to optimize a radiation-treatment plan by permitting isocenters of various radiation-treatment fields as comprise the parts of a same treatment plan to not be coincidental with one another to thereby yield an optimized treatment plan.
- optimization comprises iteratively assessing alternatives to a given plan to typically identify a series of successively-better plans.
- this reference to not being “coincidental” can refer, by one approach, to being completely non-coincidental.
- the isocenters of at least certain beams are completely exclusive of one another. These teachings are not limited in these regards, however. Accordingly, if desired, this reference to not being “coincidental” can include not being substantially coincidental.
- the isocenters of certain beams may be, for example, partially overlapping with one another but not more than, say, ten percent overlapping, twenty-five percent overlapping, forty percent overlapping, fifty percent overlapping, sixty percent overlapping, or some other figure of merit as desired.
- this step of permitting isocenters of various radiation-treatment fields to be non-coincidental can comprise scattering those isocenters around, for example, a predetermined point (such as the center of the planned treatment volume).
- this step provides for causing an area of highest energy flux for a given field to be non-coincident for at least some of the other radiation-treatment fields of that same treatment plan.
- FIGS. 7 and 8 provide illustrative examples in these regards. These figures illustrate, for example, an energy fluence 701 and an opening ratio matrix 801 that comport with these teachings and that are very different from the prior art approach typified in FIGS. 2 and 3 .
- the central minimum in the opening ratio matrix 801 has nearly disappeared (especially when compared to the opening ratio matrix 301 shown in FIG. 3 ).
- the energy flux is now delivered more efficiently as compared to the previous practices described above.
- FIGS. 9 and 10 provide a further illustrative example in these regards.
- these examples presume a simple IMRT treatment employing two opposing beams 901 (having a corresponding isocenter 902 ) and 903 (having a corresponding isocenter 904 ).
- This example clearly illustrates the use of non-coincident isocenters 902 and 904 .
- the required flux 701 and 702 is divided as shown in FIG. 10 to yield more efficient opening ratio matrixes.
- FIG. 11 provides a multi-field-based view of a planned treatment volume 100 where each field has a corresponding isocenter 1101 that is fully non-concentric with all other field isocenters 1101 and where those isocenters 1101 are themselves scattered more or less equally about a central point 1102 .
- the central maxima of the fields do not all meet at a common isocenter. Instead, the resulting dosage is distributed considerably more evenly across the planned treatment volume 100 .
- the patient-support surface (such as a couch) can be selectively shifted slightly in-between at least some of the radiation pulses.
- the conical shape of a flattening-filter-free beam can be utilized in conjunction with IMRT optimization without tending towards the creation of flat fluences.
- the platform 1200 includes a control circuit 1201 that operably couples to a memory 1202 .
- a control circuit 1201 can comprise a fixed-purpose hard-wired platform or can comprise a partially or wholly programmable platform. These architectural options are well known and understood in the art and require no further description here.
- This control circuit 1201 is configured (for example, by using corresponding programming as will be well understood by those skilled in the art) to carry out one or more of the steps, actions, and/or functions described herein.
- the memory 1202 may be integral to the control circuit 1201 or can be physically discrete (in whole or in part) from the control circuit 1201 as desired. This memory 1202 can also be local with respect to the control circuit 1201 (where, for example, both share a common circuit board, chassis, power supply, and/or housing) or can be partially or wholly remote with respect to the control circuit 1201 (where, for example, the memory 1202 is physically located in another facility, metropolitan area, or even country as compared to the control circuit 1201 ).
- This memory 1202 can serve, for example to store the aforementioned patient information and/or treatment-platform information. This memory 1202 can also serve to non-transitorily store the computer instructions that, when executed by the control circuit 1201 , cause the control circuit 1201 to behave as described herein.
- this reference to “non-transitorily” will be understood to refer to a non-ephemeral state for the stored contents (and hence excludes when the stored contents merely constitute signals or waves) rather than volatility of the storage media itself and hence includes both non-volatile memory (such as read-only memory (ROM) as well as volatile memory (such as an erasable programmable read-only memory (EPROM).)
- such a platform 1200 can further include one or more user interfaces (not shown) of choice (including user-input mechanisms and/or user-output mechanisms of choice).
- the control circuit 1201 can also be configured to communicate compatibly with one or more networks 1203 of choice including but not limited to the Internet.
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US16/255,086 US10549119B2 (en) | 2016-03-25 | 2019-01-23 | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
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US15/080,685 US10226643B2 (en) | 2016-03-25 | 2016-03-25 | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
US16/255,086 US10549119B2 (en) | 2016-03-25 | 2019-01-23 | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
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US15/080,685 Continuation US10226643B2 (en) | 2016-03-25 | 2016-03-25 | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
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US10549119B2 true US10549119B2 (en) | 2020-02-04 |
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US16/255,086 Active US10549119B2 (en) | 2016-03-25 | 2019-01-23 | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
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US10226643B2 (en) * | 2016-03-25 | 2019-03-12 | Varian Medical Systems International Ag | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
US11679273B2 (en) | 2020-09-24 | 2023-06-20 | Siemens Healthineers International Ag | Method and apparatus to deliver therapeutic radiation to a patient using field geography-based dose optimization |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
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US20110033028A1 (en) | 2006-02-21 | 2011-02-10 | Parsai E Ishmael | Unfiltered Radiation Therapy |
US20130150646A1 (en) | 2011-11-23 | 2013-06-13 | Christian Scholz | Method for the Operation of a Radiotherapy System and a Radiotherapy System |
US10226643B2 (en) * | 2016-03-25 | 2019-03-12 | Varian Medical Systems International Ag | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
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Publication number | Priority date | Publication date | Assignee | Title |
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US20110033028A1 (en) | 2006-02-21 | 2011-02-10 | Parsai E Ishmael | Unfiltered Radiation Therapy |
US20130150646A1 (en) | 2011-11-23 | 2013-06-13 | Christian Scholz | Method for the Operation of a Radiotherapy System and a Radiotherapy System |
US10226643B2 (en) * | 2016-03-25 | 2019-03-12 | Varian Medical Systems International Ag | Method and apparatus pertaining to optimizing a radiation-treatment plan by permitting non-coincidental isocenters |
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US10226643B2 (en) | 2019-03-12 |
US20190151680A1 (en) | 2019-05-23 |
US20170274224A1 (en) | 2017-09-28 |
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